Evolution or revolution? Has the government caught up on current practice since the 2016 Childhood Obesity Plan?

Michael Chang

Yesterday the government published the long-awaited second chapter of its plan to significantly reduce childhood obesity in Britain. Childhood Obesity: A Plan for Action highlights that now nearly a quarter of children have become obese by the time they start primary school at five years of age.

The latest plan sets the ambition to halve childhood obesity by 2030. Like the initial 2016 plan there is a strong emphasis on reforming our food environment and increasing physical activity to tackle the fundamental root cause of obesity. Unlike the 2016 plan, though, which didn't grasp the important role of town planning to promote healthier environments, this plan does proposes measures to harness planning powers, which should be welcomed.

As the nation tries to digest the proposals put forward in the latest chapter of this plan (on some of the hottest days of 2018!), let’s take a closer look at elements of the document relevant to town planning and reflect on how they have developed over the last few years.

Firstly lets put this plan into perspective in the form of a timeline. The 2007 Tackling Obesities report, released as part of the government’s Foresight programme, predicted that by 2025 21% of boys and 14% of girls aged 6-10 years would be obese. In essence, we have realised this prediction nearly nine years early.

The Foresight report proposes that planners have a potential influence over two domains: to encourage physical activity and active travel, and to restrict proliferation of unhealthy food. It wasn’t until seven years later that the Planning Practice Guidance on health and wellbeing included a reference to restricting takeaway food, followed last year by an update to include a specific section on promoting healthier food environments. This year’s draft revised National Planning Policy Framework proposes to move requiring planning to facilitate access to healthier food from the Planning Practice Guidance properly into the NPPF.

So we can see that the journey from evidence to policy to local authority action does take time – a long time – but it is happening.

Secondly, the plan wants to support local authorities to use greater planning powers to manage proliferation of fast food outlets on the high streets and in close proximity to schools. For the purpose of this commentary, it assumes that planning powers mean the use of planning policy. The parliamentary select committee on health and social care has already highlighted this issue in its last three inquiries into childhood obesity since 2016. The plan recognises that councils already have a range of powers to do this and, since Waltham Forest first adopted the supplementary planning document in 2009 many others have also followed suit. Emerging research by the Centre for Diet and Activity Research will support this.

So the question is, as councils already recognise they have the necessary powers, are they utilising them? TCPA research from 2014 on the subject of planning healthy weight environments [1], supported by Public Health England, found that nearly 60% of councils did not set out policies to join up obesity and the built environment in local plans — and a surprising 82% of joint health and wellbeing strategies did not either. So the answer is no but practices may have improved since and this research would require an update.

The plan also recognises that councils already have powers to develop planning policies to prioritise active travel and ensure access to quality green space. Well, initial indications from TCPA research, as part of its 2018 health project[2], supports this, with 99% of local plans having open space policies and 100% having active travel policies. So the answer is yes but not quite for reason of tackling obesity but for achieving other outcomes.

In essence, the planning system is already facilitating opportunities for healthy active living and healthier food environments. By taking a closer look at local plan examination reports, one can already appreciate that councils, with the support of planning inspectors, are taking bold action to put health right at the heart of planning.

But the picture is more mixed during planning appeals when planning applicants appeal against the council’s refusal for new A5 fast food outlets. This is why the plan’s proposal to provide training for planning inspectors should be strongly welcomed, and is something the TCPA has highlighted in its 2016 report with the Local Government Association (LGA)[3].

So given the above commentary, why is there such a disconnect between policy and practice, as it is clear that government and national and local politicians do not feel that effective actions are being taken by local authorities?

For answers, readers will have to wait until later in 2018 when the TCPA publishes its report on planning for health progress (five years since reunification of public health with planning in local authorities[2]) and through further academic research findings[4] in 2019. But initial indications from the range of local engagement the TCPA has undertaken as part of its Reuniting Health with Planning initiative are that there are wider and more fundamental forces at play that transcend just public health issues. There are issues relating to development management of planning applications, financial and viability constraints, local authority skills and capacity, engagement of health stakeholders in the planning process, and quality of localised evidence, all of which contribute to inconsistent local action.

So as the nation celebrates both the 70th anniversary of the National Health Service and its big brother, the Town and Country Planning Act, the planning system’s founding legislation, there is no better time to translate policy into action. Put simply, there is no time to waste. We all need to get off the couch and start activating the learning built up over the years. The time for learning lessons is over. The time for action is now.

[3] TCPA and LGA, 2016, Building the Foundations: tackling obesity through planning and development

[4] Michael Chang is currently researching the use of planning powers to promote healthy weight environments at Leeds Beckett University as part of its whole systems approach to tackling obesity project.

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